During the early months of my residency, I encountered a patient whose journey has stayed with me ever since. She arrived at the emergency department in a state of heightened activity: singing, dancing, and radiating an infectious energy. For a fleeting moment, her exuberance felt uplifting. Yet, this was not joy in its truest sense; it was a manifestation of a manic episode in bipolar disorder.
Her admission marked the beginning of a prolonged and challenging course. Due to significant treatment resistance, her hospital stay extended to nearly six months. Over time, as her symptoms gradually came under control, I came to know her beyond her diagnosis.
She had experienced a marital separation and had single-handedly navigated her child’s serious medical illness. Subsequently, she lost custody of her child. Her attempts at treatment were further complicated by resistance from her in-laws, who questioned medical care and created significant barriers. Her difficult marriage and divorce were not just a life event but a verdict that she was unlovable and unworthy. Amidst these struggles, one question surfaced repeatedly: “When will I truly be happy?”
Over the course of my residency, she required readmission on two occasions. Each time, the work extended beyond pharmacological management. We worked, often in small steps, on separating her identity from her illness and her marital status. Through repeated discussions, she began to reframe her narrative from someone who had “failed” in marriage to someone who had endured hardship and continued to persist.
By the end of my three years of treating her, she had initiated a small home-based sweets business with her mother. Importantly, her self-worth was no longer contingent on the presence of a partner. In our final interaction, I asked her if she was happy now. She smiled and said, “I’m on the road to being happy.” That response stayed with me. It reframed my understanding of happiness, which is not always a destination we arrive at, but often a direction we choose.
Dr. Simran Sandhu
Senior Resident
GMC Bhopal
